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Bupropion is one of the top-selling antidepressants in the world. A second use for this drug is as an aid to smoking cessation efforts.
Prescribed to treat major depressive disorder, SAD (seasonal affective disorder) and ADHD (attention deficit hyperactivity disorder), bupropion works to restore the balance of certain neurotransmitters in the brain. The mechanism through which it accomplishes this, however, is not well understood.
Bupropion was patented in 1969 by Burroughs Wellcome, which later became part of GlaxoSmithKline. It was not approved for clinical use in the United States until 1989. It is sold under a number of trade names, including Wellbutrin.
Bupropion is a different kind of antidepressant from most. It is neither a selective serotonin uptake inhibitor (SSRI) nor a Monoamine Oxidase Inhibitor (MAOI), as are most popular antidepressants. It is a very effective antidepressant on its own, but is also highly effective prescribed in addition to SSRIs. It does not have the common side effects of weight gain or sexual dysfunction that many other antidepressants have.
In smaller doses, bupropion is also prescribed under trade names Prexaton, Voxra and Zyban as a smoking cessation aid, helping smokers fight cravings and withdrawal symptoms. This treatment generally lasts seven to twelve weeks, with the smoker stopping their use of cigarettes after about ten days. In Australia and the UK smoking cessation is the only authorized prescribed use of bupropion.
In 2006 the US Food and Drug Administration (FDA) approved the use of buproprion to prevent the occurrence of Seasonal Affective Disorder. This is a seasonally occurring episode of depression that fully remits during the remainder of the year. Depending upon geographic location, SAD has prevalence between 1.4% in Florida and 9.7% in New Hampshire.
There have been trials on the efficacy of using buproprion as a treatment for ADHD. While there have been claims of successful outcomes in treatment of ADHD, trials have brought inconclusive results. The American Academy of Child and Adolescent Psychiatry rates buproprion as a "second-line agent" in the treatment of ADHD.
It is important to realize that a small number of patients (especially those aged 25 or under) might experience new or worsening depression, suicidal thoughts or attempts, or other moods or symptoms upon starting any type of antidepressant. If this happens when beginning to take bupropion medical help should be sought immediately.
Seizures are a possible side effect of taking bupropion. The risk of seizures increases as dosage levels increase. Because of this, bupropion should not be prescribed to those who take certain medications or have certain disorders. For those stopping regular use of benzodiazepines or alcohol just before starting bupropion, seizure risk is higher. Any seizure activity should be reported immediately to the prescriber.
Bupropion is also not appropriate for anyone who suffers from anorexia nervosa or bulimia.
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